Successful treatment of post-splenectomy sepsis in an 82-year-old male.

Six weeks after splenectomy for idiopathic thrombocytopenic purpura an 82-year-old man suddenly became drowsy with pyrexia and neck stiffness. Pneumococcal meningitis was diagnosed and treated with benzyl penicillin. Subsequently, penicillin-sensitive pneumococci (serotype 23) were isolated from both CSF and blood. He recovered fully. Review of recent literature confirms that absence of the spleen predisposes to overwhelming infection with encapsulated organisms in adults as well as in children. Use of pneumococcal vaccine would appear to be a prudent, if untested measure in all patients undergoing splenectomy.